Sero-diagnosis of Hepatitis C Virus infection in IDPs of Waziristan Residing at Bannu Camp in 2014

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1 Journal of Bio-Molecular Sciences (JBMS) (2014) 2(3): Sero-diagnosis of Hepatitis C Virus infection in IDPs of Waziristan Residing at Bannu Camp in 2014 Azam Hayat 1, Fazal Malik 2, Muhammad Daud* 1 and Muhammad Mushtaq 3 1 Department of Microbiology Hazara University Mansehra, Khyber Pakhtunkhwa, Pakistan 2 Medical C Unit Lady Reading Hospital Peshawar, Khyber Pakhtunkhwa, Pakistan 3 Department of Animal Husbandry and Poultry Sciences, Agriculture University Peshawar, Khyber Pakhtunkhwa, Pakistan Received 17 Oct. 2014; Accepted 25 Oct. 2014; available online 30 Oct Abstract: HCV is highly prevalent in Khyber Pakhtunkhwa (KPK) Pakistan. To check the Serological prevalence of Hepatitis C infection in IDPs of Waziristan residing at Bannu Camp, this Research study was conducted in the Blood Bank main laboratory of Hayatabad Medical Complex Peshawar Khyber Pakhtunkhwa. Samples were collected from the IDPs Patients in the month of July and brought it in closed icebox container to the laboratory of Hayatabad Medical Complex, Peshawar. HCV infection was diagnosed on the basis of RDT Rapid Diagnostic Test and Serologic test by using Enzyme linked Immuno Sorbent Assay (ELISA). Out of 500 patients high prevalence was observed in age group of years which was 82.17% while in age group years the prevalence was 61.11%. The lowest prevalence was observed in the age group of 20-40, which was 55%. The data was significant when analyzed by chi square test with P<0.05.In gender wise, high prevalence was observed in females which were 72.69% while in children it was 50%. The lowest prevalence was observed in the males (66.66%). It was concluded from the present study that Hepatitis C Virus infection was more prevalent in IDPs of North Waziristan. This study will be helpful to the health care policy makers to design strategies for controlling and eradication of Hepatitis C infection. Key words: Hepatitis C, Serological, Anti-HCV, Patients Introduction Hepatitis C infection is one of the major causes of liver diseases all over the world. HCV is the main cause of Hepatitis C infection and the majority of patients with chronic hepatitis is untreated, which may cause hepatocellular carcinoma (HCC) and finally liver cirrhosis (Hoofnagle, 2002). Hepatitis C virus belongs to the family Flaviviridae and is an RNA virus (Ogata et al, 1991; Lindenbach et al, 2007). Hepatitis *Correspondence to: Muhammad Daud, Department of Microbiology Hazara University Mansehra, KhyberPakhtunkhwa, Pakistan, ; khattaks2010@gmail.com

2 Hayat et al. 73 C virusis the principal source of chronic liver disease (Poynard et al., 2000) with estimated million infected persons globally (Butt et al., 2010) counting about 17million in Pakistan (Idrees et al., 2008). The main cause of HCV transmission in Khyber Pakhtunkhwa is multiple use of syringes, minor and major surgery, dental procedures, blood and blood product transfusion, using of razors for multiple shaving or shaving in the shops of barbers, sharp instruments, nail cutters, tooth brushes and sexual transmission (Farhana et al, 2009; Idrees and Riazuddin, 2008). A recent report by WHO has stated that every twelfth person in the world is living either with HBV or HCV infection (World Hepatitis Alliance, 2009).World data shows that HBV with combination of HCV accounts for 75% of all cases of liver diseases. These diseases are highly endemic in Asian countries (Qureshi, 2008). Khyber Pakhtunkhwa is an endemic area for hepatitis B & C. Some recent studies have reported prevalence of HBV and HCV to be 2.5% and 5% respectively (World Health organization, 2000). Hepatitis C is caused by HCV virus it is an infectious disease of liver. Initially it is asymptomatic and gradually progressing to hepatocellular carcinoma and cirrhosis in a no of patients (ALI et al., 2011). In the world there are about 170 million patients with HCV Infection among them every year 3 to 4 million new cases were diagnosed (Re and Kostman, 2005; Kim, 2002). In developing country Pakistan 170 million people has alarmingly rate of outbreaks of HCV (Bari et al., 2001; Kabir et al., 2006; Syed and Jamal, 2006; Ali et al., 2010) which need proper diagnosis. Seroprevalence studies of anti-hcv antibodies in the general population of Pakistan have been recorded as 5.31% to 7.5% (Khokhar et al., 2004; Luby et al., 1997; Syed et al., 2009).The prevalence of hepatitis C virus infection is in the range of 4.1 to 36% reported from various areas of KPK Khyber Pakhtunkhwa Province (Khattak et al., 2008; Ali et al., 2007). Materials and Methods Study samples A total of 500 blood samples were collected from the IDPs of Waziristan which were residing in camp at Bannu. With the help of sterile disposable syringe 5ml of blood sample was collected from each suspected patient for further processing blood was stored in EDTA tube. EDTA tube was stored at cooled temperature and brought it to the Blood Bank of Hayatabad Medical Complex Peshawar for RDT (Rapid diagnostic test) and ELISA Enzyme Linked Immuno-sorbent Assay). Statistical Analysis SPSS version 14.0 for windows was used for the statistical analysis of the data. The results were obtained in rates (%) Results A total of 500 HCV samples were observed out of which, high prevalence was observed in age group of years which was 189 (82.17%) while in age group years the prevalence was 55 (61.11%). The lowest prevalence was observed in the age group of which was 99 (55%) (Table 1, Fig. 1). The data was significant when analyzed by chi square test with P<0.05. In gender wise prevalence, high prevalence was observed in females, which was 189 (72.69%) while in children it was 75 (50%). The lowest prevalence was observed in the males 60 (66.66%) (Table 2, Fig. 2).

3 TOTAL NO OF HCV PATIENTS Sero-diagnosis of Hepatitis C Virus infection in IDPs of Waziristan 74 Table 1. Age wise prevalence of Hepatitis C. Age of the Total Total Positive Samples Prevalence of HCV Patients Samples of of HCV HCV % % % Total %. Fig. 1: Age wise prevalence of Hepatitis C Age wise prevalence of Hepatitis C Total AGE OF HCV PATIENTS Total Positive Samples Total Samples Percentage Total Samples Total Positive Samples Percentage

4 TOTAL NO OF HCV PATIENTS Hayat et al. 75 Table 2. Gender wise prevalence of Hepatitis C. Sex Total Samples of Positive Prevalence of HCV HCV Samples of HCV Children % Male % Female % Total % Figure 2. Gender Wise prevalence of Hepatitis C Gender wise prevalence of Hepatitis C Children Male Female Total Positive Total Samples Percentage Total Samples Positive Percentage

5 Sero-diagnosis of Hepatitis C Virus infection in IDPs of Waziristan 76 Discussion A total of 500 HCV samples were observed, out of 500, the high prevalence was observed in age group of years which was 82.17%. While in age group years the Prevalence was 61.11%. The lowest Prevalence was observed in the age group of which was 55%. Our result is similar with the research of Abida et al. (2013) concluded that the Prevalence was higher in age groups of years and lower was in the age group of years. In rising states of the world hepatitis C is Key health problem. At the onset of infection the signs and symptoms of this disease is very mild (Saha et al., 2000), so the epidemiology of this virus is less understood. In gender wise prevalence high prevalence was observed in females which was 72.69% while in children it was 50%the lowest prevalence was observed in the males 66.66% our result was similar to the research of (Waseem et al., 2014) He observed 582 patients for active HCV the total Prevalence he recorded was 56.5% out of the total samples 267 were male and 315 were female in which the rate of Hepatitis C virus infection 59.9% and 53.6%. Our results also show similarity with Abida et al. (2013). As in Pakistan more of the peoples are living below the life standard so most of them came to know about their disease in advance stages. In developing countries diagnostic of HCV is done mostly by Immuno chromatographic Technique (ICT) and Enzyme Linked Immuno Sorbent Assay (ELISA) (Ji-Su et al., 1995). Conclusion It was concluded from the present study that Hepatitis C Virus infection was more prevalent in IDPs of North Waziristan. Patients with age group above 40 were found with high rate of HCV infection. In females it was more as compared to males. There is a definite need for health education in our society and health awareness programs through print and electronic media regarding HCV infection. This study will be helpful to the health care policy makers to design strategies for controlling and eradication of Hepatitis C infection. References Abida, A., Habib, U.K., Farzana., Mehwish., S., Aslam, Tayyab, R., Muhammad, A., Muhammad, S., Ahmed, I., Ali and Ahmad U.R.S Seropositivity and Active HCV Infection in Patients from Peshawar Division of Khyber Pakhtunkhwa Province, Pakistan Pak. J. Zool. 45(6): Ali, A., Ahmad, H. and Idrees, M Molecular epidemiology of Hapatitis C Virus Genotypes in Khyber Pakhtunkhwa of Pakistan. Virology J. 7: 203. Ali, I., Khan, N.U., Ahmad, N.U., Iqbal, A., Rehman, L.U., Munir, I., Rehman, M.U., Khan, S., Ali, S., Siddique, L. and Swati, Z.A Prevalence of active HCV infection among the blood donors of Khyber Pakhtunkwa and FATA region of Pakistan and evaluation of the screening tests for anti- HCV. Virol J. 8: 15. Ali, S.S., Ali, I.S., Amir, A.M., Jadoon and Z., Inayatullah, S Frequency of Hepatitis-C infection in Diabetic Patients. J Ayub Med. Coll. Abbottabad. 19: Bari, A., Akhtar, S. and Rahbar, M.H Risk factors for hepatitis C virus infection in male adults in Rawalpindi-Islamabad, Pakistan. Trop. Med. Int. Health, 6: Butt, S., Idrees, M., Akbar, H., Rehman, I., Awan, Z and Afzal S The changing epidemiology pattern and frequency distribution of hepatitis C virus in Pakistan. Infect. Genet. Evol. 10(5): Farhana, M., Hussain, I and Haroon T.S Hepatitis C. the dermatologic profile, J. Pak. Assoc. Derm. 18: Hoofnagle, J.H Course and outcome of hepatitis C. Hepatol. 36(5):

6 Hayat et al. 77 Idrees, M. and Riazuddin S Frequency distribution of hepatitis C virus genotypes in different geographical regions of Pakistan and their possible routes of transmission. BMC Infect. Dis. 8: 69. Idrees, M., Lal, A., Naseem, M and Khalid M High prevalence of hepatitis C virus infection in the largest province of Pakistan, J. Dig. Dis, 9: Ji-Su, L.I., Torg, S.P., Vitvitiski, L and Trepo, C Single step nested PCR for detection of different genotypes of hepatitis C virus. J. Med. Virol. 45: Kabir, A., Alavian, SM. and Keyvani, H Distribution of hepatitis C virus genotypes in patients infected by different sources and its correlation with clinical and virological parameters: a preliminary study. Comparative Hepatol. 5: 4. Khattak, M.N., Akhtar, S., Mahmud, S. and Roshan, T.M Factors influencing Hepatitis C virus sero-prevalence among blood donors in North West Pakistan. J Public Health Policy, 29: Khokhar, N., Gill, M.L. and Malik, G.J General Seroprevalence of hepatitis C and hepatitis B virus infections in population. J. Coll. Physicians Surg. Pak. 149: Kim, W.R Global Epidemiology and Burden of Hepatitis C. Microbes Infect. 4: Lindenbach, B.D., Thiel, H.J. and Rice, C.M Flaviviridae: the viruses and their replication. Williams and Wilkins, Philadelphia, P.A. (Eds. 5). In Fields virol. 5: Luby, S.P., Qamruddin, K. and Shah, AA The relationship between therapeutic injections and high prevalence of hepatitis C infection in Hafizabad, Pakistan. Epidemiol Infect. 119: Muhammad, W., Asad, U.K., Bakth, B., Muhammad, W., Noor, U.A., Razi, U., Muhammad, A.S., Muhammad, A., Akram, K., Sarfaraz, A.T., Sana, U., Muhammad I.K., Hayan, U. and Tahir, S Prevalence of active HCV Infection and identification of its common Genotypes in District Mardan, Pakistan. Int. Res. J. Medical Sci. 2(4): Ogata, N., Alter, H.J., Miller, R.H and Purcell R.H Nucleotide sequence and mutation rate of the H strain of hepatitis C virus. Proc. Natl Acad. Sci. 88: Poynard, T., Ratziu, V., Benhamou, Y., Opolon, P., Cacoub, P. And Bedossa P Natural history of HCV infection. Bestpract Res. Clin. Gastroenterol. 14: Qureshi, H Prevalence of Hepatitis B and C in Pakistan: 1st population Based Survey.Proceedings of the 2nd Annual Meeting of Pakistan Society for the study of Liver Diseases; Nov, 27 29, Karachi, Pakistan. Re, V.L. Kostman, JR Management of chronic hepatitis C. Postgrad. Med. J. 81: Saha, M.K., Chakrabarti, S., Panda, S., Naik, T.N., Manna, B., Chatterjee, A., Detels, R. and Bhattacharya, S.K Prevalence of HCV and HBV infection amongst HIV seropositive intravenous drug-user and their non-injecting wives in Mirpur India. Indian J. Med. Res.111: Syed, A.A., Rafe, M.J., Qureshi, H. and Vermund, SH Hepatitis B and hepatitis C in Pakistan. Int. J. Infect. Dis.13: Syed, T. and Jamal, M.M Epidemiology of hepatitis C virus (HCV) infection. Int. J. Med. Sci.3: World Health organization Hepatitis B (Fact sheet no. 204) Geneva, Switzerland: World Health Organization. World Hepatitis Alliance Http/